Heart Disease- Let's Reduce the Risk

One third of those who are reading this likely suffer from heart disease and many of you are unaware of your risk. It is a sobering fact that highlights the need for both prevention and treatments that address the root cause of disease. Often, as doctors, our first investigation for signs of dysfunction is blood tests. We look at a multitude of things depending on your age and health history to give us an idea of what health risks may exist. Cholesterol is undoubtedly an important part of these blood tests and until recently, was the principal information we used to understand your cardiovascular health. This is problematic because half of the people who suffer heart attacks have normal cholesterol numbers! Fortunately, research has led to incredible advancements in testing; bringing about a new age of preventative medicine that identifies hidden health risks.

As part of our ongoing commitment to preventative medicine and optimal health, we are excited to be offering advanced cardiovascular testing through Boston Heart Diagnostics (BHD). Founded in 2007, BHD is now recognized as the world leader in personalized diagnostics dedicated to preventing heart disease and related events (stroke, heart attack, etc). Their clinical staff has been at the forefront of cardiovascular research for over 30 years, with 500+ scientific publications and numerous scientific awards. With a simple blood test we are able to learn more about your heart health and unique cardiovascular disease risks than ever before. BHD works with many of the insurance companies in our area and for often just a nominal co-pay, patients are now able to learn more about their heart health and uncover hidden health risks better than ever before.

Today, we know that testing for cardiovascular disease should include new areas of concern: inflammation, metabolic health, and genetics. Together with cholesterol, these health markers paint a more realistic portrait of your current cardiovascular function and future risks, allowing treatments to be individualized based upon your areas of concern.

Advanced cardiovascular testing expands on the idea that elevated cholesterol increases disease risk but we are now able to look deeper into cholesterol particles themselves—their size, how sticky they are, and where they come from. In the case of HDL cholesterol, the good cholesterol, we can now test how the HDL molecule is maturing through its lifecycle. Simply knowing how many HDL particles you have is not an accurate understanding of whether or not those particles are working to remove plaque and lower your risk factors. I think of HDL like a bus that drives around inside the artery, picking up the bad particles and taking them back to the liver to be processed out of the body. Ideally, you should have large double-decker buses to pick up the bad cholesterol rather than a small, short bus. When HDL abnormalities are discovered, often simple nutrient and lifestyle interventions can lead to improvement.

In addition to cholesterol, metabolic testing is important to identify early signs of blood sugar variations that can affect your diabetes risk and blood vessel health. If the body is not properly utilizing the sugar found in your blood, it can lead to inflammation and scarring on the inside of the blood vessel, contributing to elevations in blood pressure and other cardiovascular risks.

Genetic markers are tested to give you a sense of how your body creates and stores cholesterol, how inflammation in the arteries can be improved, and how certain gene variations can lead to Alzheimer’s risk and dementia. In terms of cholesterol, approximately 75% is made in the liver, and 25% is absorbed directly from the intestines in the foods we consume. In some cases, patients are identified as either genetic over-producers or over-absorbers of cholesterol—which has serious implications in how we treat them in cases of heart disease. For example, if you are over-producing cholesterol, you may be better treated with a statin drug or supplements that act within the liver to lower the production of cholesterol. In comparison, if you have over-absorption of cholesterol from the intestines, then diet and lifestyle interventions, in addition to medication or nutrients that bind cholesterol in the gut, will lead to better health outcomes. When a statin drug is necessary to stabilize a high-risk patient, genetic testing can now identify which statins will be safe for use and minimize side effect risks.

The inflammation panel is a key component of advanced cholesterol screening that helps give a complete picture of cardiovascular disease risk. Inflammation markers accurately predict where you are in terms of progression towards atherosclerosis (plaque buildup, narrowing and hardening of the arteries). Cardiovascular inflammation is the new metric by which we judge risk. If your inflammation markers are elevated then your risk for cardiovascular disease is much higher than those with normal levels.

If you are concerned about your heart health or if you are taking a medication for high cholesterol, high blood sugars or high blood pressure then you may be a good candidate for advanced cardiovascular lab testing. Schedule a visit to discuss if Boston Heart testing is right for you. Let us make sure every heartbeat is bringing you closer to optimal health!

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